While liver conditions like jaundice, hepatitis, and liver infections have long been recognised health concerns, experts are now seeing a sharp rise in fatty liver disease among young adults. What was once considered a condition linked mainly to obesity and older age is now increasingly affecting people in their 20s and 35s.
Experts warn that beyond weight gain, factors such as chronic stress, poor sleep, unhealthy eating habits, and sedentary lifestyles are silently contributing to this growing trend. They emphasise the importance of timely screening, regular health check-ups, and simple lifestyle changes like a balanced diet, physical activity, and adequate sleep to prevent long-term liver damage.
Fatty liver disease occurs when excess fat builds up in the liver, affecting its normal function. In many cases, it may not cause noticeable symptoms in the early stages, which is why it often goes undetected. However, some people may experience fatigue, mild abdominal discomfort, or unexplained weight changes. " The most affected age group is typically 25 to 40 years, with an increasing number now seen in the early 20s, especially among working professionals, IT employees, students, shift workers, and those with sedentary lifestyles. We are also seeing cases in people who are not obese, the so-called “lean fatty liver” phenotype, particularly common in South Asians. Hidden triggers include chronic stress leading to hormonal imbalance and insulin resistance, poor sleep/sleep deprivation, which worsens metabolism and liver fat accumulation,
Long sitting hours and low physical activity, frequent intake of ultra-processed foods, sugary drinks, and late-night meals, weight gain around the abdomen despite normal BMI, prediabetes, high triglycerides, and metabolic syndrome. The biggest challenge is that fatty liver is often silent in the early stages. Many young adults discover it only when liver enzymes rise, ultrasound shows fat deposition, or metabolic problems such as diabetes begin. Fatty liver is no longer a disease of middle age. It is now a young adult lifestyle disease, but fortunately, in most early cases, it is reversible with timely action. If left untreated, fatty liver can progress to more serious conditions such as liver inflammation, fibrosis, cirrhosis, and even liver failure over time. The condition often remains silent until it progresses, which is why early screening and awareness are extremely important. Timely diagnosis through simple blood tests and imaging can help detect fatty liver at an early stage and prevent complications,” said Dr. Chetan Kalal, Assistant Director – Hepatology, Gleneagles Hospital, Parel.
Dr. Chetan further added, “In most cases, the condition is reversible if identified early. Treatment mainly focuses on lifestyle modification, including a balanced diet, regular exercise, stress management, and improving sleep quality. Avoiding processed foods and limiting sugar intake can improve liver health. Preventive care and consistent follow-up are key to ensuring long-term recovery and reducing the risk of advanced liver disease.”
“Obesity has long been recognised as a major risk factor for fatty liver, as excess body fat accumulation leads to inflammation of the liver. This is now known as "Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD). The other risk factors for MASLD include type 2 diabetes. However, we are now seeing an increasing subset of the population who develop MASLD despite being lean but have at least 2 associated metabolic risk factors.
The risk factors for developing fatty liver are genetics, lifestyle-related factors, gut microbiome dysbiosis, lipotoxicity, and increased oxidative stress. This shift makes it important to look beyond weight alone and assess overall metabolic health to protect the liver. Now at least 50 to 60% of all OPD patients have fatty liver," said Dr. Aparna Govil Bhasker, Consultant Bariatric, Hernia and Laparoscopic Surgeon, MetaHeal Clinic, in Mumbai.
Dr Aparna further added, "Most often, fatty liver may not present with any symptoms and is incidentally diagnosed on a sonography. Symptoms may be nonspecific and include mild fatigue, loss of appetite, a feeling of fullness or heaviness in the upper abdomen, and mild swelling or bloating.
Fatty liver is now associated with an increased risk of acquiring heart disease, kidney issues, and sleep apnoea. If not addressed in time, it can progress to serious complications like inflammation, fibrosis, and cirrhosis of the liver, which may eventually require advanced interventions. So next time you get a report with fatty liver, please do not ignore it. Visit a specialist and take their advice. The focus should be on a holistic approach that includes weight management where needed, along with sustainable lifestyle changes, balanced nutrition, and long-term monitoring to protect liver health.